Pain physician
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The analysis of epidural procedure utilization has revealed several notable trends over recent years. Utilization increased significantly until 2004, then rose minimally until 2011, followed by gradual declines up to 2019 in the Medicare population. The COVID-19 pandemic led to a marked 19% decline in usage from 2019 to 2020. Additionally, recent studies of interventional pain management techniques showed a 28.9% reduction in use from 2019 to 2022, leading to an average annual decline of 10.9%. ⋯ This two-decade analysis indicates significant shifts in epidural procedure utilization, with steady increases until 2010, followed by a general decline affected by COVID-19 and other contributing factors. An approximate 24% decline in epidural procedure visits for chronic spinal pain management was noted from 2019 to 2022.
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Observational Study
Relationship Between Preoperative Serum Albumin and Uric Acid and One-year Cure Rate in Patients With Herpes Zoster.
Herpes zoster (HZ) is a common condition that causes severe pain mostly in middle-aged and older adults. It is currently treated with a combination of medication and surgery. However, some patients do not experience complete pain relief even after surgery and often experience a period of mild pain until a complete cure. Some studies suggest that the development of HZ is markedly associated with antioxidant factors; however, the relationship between preoperative antioxidant factors and the prognosis of HZ remains undetermined. ⋯ ALB and UA are independent risk factors and reflect the prognosis of patients with HZ neuralgia. Furthermore, their combined application may improve prediction accuracy.
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Randomized Controlled Trial
Effect of Epidural Volume Extension Using Low-Dose Sufentanil Combined with Low-Concentration Ropivacaine on Visceral Pain During Cesarean Sections: A Randomized Trial.
Visceral pain is common in cesarean sections conducted under combined spinal-epidural anesthesia (CSE). Epidural volume extension (EVE) is a technique for enhancing the effect of intrathecal blocks by inducing epidural fluid boluses in the CSE. Whether EVE that uses different drugs can reduce visceral pain during cesarean sections is rarely studied. ⋯ EVE at 15 minutes after spinal anesthesia with a 10 mL combination of low-dose sufentanil (10 mu-g) and low-concentration (0.15%) ropivacaine can effectively reduce the incidence and severity of visceral pain in cesarean sections under CSE. At the same time, using EVE in this way can reduce postoperative opioid consumption and improve intraoperative satisfaction.
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Recent research underscores the potential of intradiscal biologics, such as mesenchymal stem cells (MSCs), platelet-rich plasma (PRP), and alpha-2-macroglobulin, in promoting chondrogenesis within lumbar intervertebral discs as a treatment for discogenic low back pain. Studies indicate significant improvements in pain relief, physical function, and overall quality of life following these interventions. ⋯ This systematic review and single-arm meta-analysis suggest that intradiscal injections of MSCs and PRP may be effective in managing discogenic low back pain, supported by Level III evidence.